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doc_tr

Matched into my 8th choice

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So I went through Carms this year applying to two different specialties, we were strongly encouraged to do so to improve match rates. Some of my classmates applied to 3 specialties, I don’t know how they had CVs good for that. Anyways I matched into my 8th choice on ROL in first iteration. Since match day I have had many different emotions. In hindsight I wish I had known many things, especially how unforgiving Carms is. The thought of not ranking a program if I don’t want to do it is easy to say but when I submitted ROL my goal was to match no matter what. I had many friends who went unmatched last year and joined our match, on Carms tour there were people who were applying with Med5 year. I have HIGH respect for them but I did not have it in me to go unmatched and do Med 5 especially with senior residents saying during the tour - if you don’t match this year don’t come back. Anyways now as I start residency I hope I can get excited once I start working, I have thought of transferring but that is like winning the lottery. If there was a way to make Carms less of a one shot deal I’m all for it, it really should not be this way.

Thanks for reading, just wanted to vent I guess. All the best to applicants going through Carms this year!

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On 6/18/2019 at 12:06 PM, doc_tr said:

senior residents saying during the tour - if you don’t match this year don’t come back.

That's bullshit, I don't know why any resident would say that, especially a senior. Stuff like that should absolutely not happen. I'm sorry that you had to go through this :( 

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Was it your first choice specialty though? If so, at most it'll suck for 5-6 years. And if it wasn't your first choice specialty, at least you'll be made handsomely and can spend that extra cash making your life outside of medicine THAT much better.

Unfortunately, CaRMS is very unforgiving. My heart broke for people who matched to a specialty they didnt want in a place they didn't want to be (especially if it was across the country)

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I matched into my back up specialty. At this point I just want to move on instead of rethinking everything I did or could’ve done differently this past year. Found out today I passed the LMCC so that’s some good news :)

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7 hours ago, doc_tr said:

I matched into my back up specialty. At this point I just want to move on instead of rethinking everything I did or could’ve done differently this past year. Found out today I passed the LMCC so that’s some good news :)

Such is life. There's probably nothing you couldve done differently that wouldve helped you match to your program of choice. A lot of it is involves being in the right place at the right time. Just remember there's a lot more to life than just medicine.

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8 hours ago, doc_tr said:

I matched into my back up specialty. At this point I just want to move on instead of rethinking everything I did or could’ve done differently this past year. Found out today I passed the LMCC so that’s some good news :)

What was your desired specialty and what did you match to, if you don't mind sharing?

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By choices I meant program options in ROL, depending on how many specialties and how broadly you apply, you may have to rank 10 to maybe 100 options as you rank each program and then each site within the program. If you go to the Carms website and click on program description you can see the programs and the sites in each program. Hope this helps...

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The whole CaRMS environment blows and I'm sorry it worked out less than optimal for you. Is your back up speciality at least something you enjoy? I assume it would be if if was a back up....

With all of this being said I think there are a few important things to be mindful of going forward:

1. You DO have the option to try and transfer and it DOES happen. Give it a shot if you want.
2. A huge part of residency, particularly years 1-2, is off-service rotations. While it's important to go into it with some level of excitement and freshness, understand that residency is still about jumping through hoops and your life will likely have a huge element of providing a service and learning skills that may not necessarily be relevant to you when you are staff in your speciality. What I want you to remember is that if you find year one to be less enjoyable then you had hoped for, try to recognize that part of it might have nothing to do with the program you matched to but more to do with what the exercise is about.
3. You matched. As you said doing an extra year of medical school is not fun. 

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These are some excellent points, I am glad to have matched but my aim in writing here was really to make people aware that you may not get your 1-3 choice. I was given the advice that you do not go down the ROL much everyone gets one of their top 3, but that is not the case. I definitely would’ve changed my ROL had I thought it would go down past the top 3-4.  

Thank you everyone for all the support, I appreciate knowing I’m not the only one in this boat this year.

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Good luck. You can always try to transfer though it is hard and many people are not successful. It's good you posted to help people be aware of how committing your rank list is. It is truly hard to leave a program once you are in it. I hope you find your specialty fulfilling.

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On 6/22/2019 at 4:19 PM, doc_tr said:

These are some excellent points, I am glad to have matched but my aim in writing here was really to make people aware that you may not get your 1-3 choice. I was given the advice that you do not go down the ROL much everyone gets one of their top 3, but that is not the case. I definitely would’ve changed my ROL had I thought it would go down past the top 3-4.  

Thank you everyone for all the support, I appreciate knowing I’m not the only one in this boat this year.

So essentially you didnt know how ROL works and that you should always rank by preference. You're implying here that had you known you could go down your list...you wouldve ranked differently. I still dont understand how this happens that very intelligent people year after year dont understand a simple algorithm..

 

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On 6/22/2019 at 8:19 AM, doc_tr said:

These are some excellent points, I am glad to have matched but my aim in writing here was really to make people aware that you may not get your 1-3 choice. I was given the advice that you do not go down the ROL much everyone gets one of their top 3, but that is not the case. I definitely would’ve changed my ROL had I thought it would go down past the top 3-4.  

Thank you everyone for all the support, I appreciate knowing I’m not the only one in this boat this year.

Lol what did you do? Rank alphabetically after your top 3-4 choices?

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On 6/18/2019 at 12:06 PM, doc_tr said:

So I went through Carms this year applying to two different specialties, we were strongly encouraged to do so to improve match rates. Some of my classmates applied to 3 specialties, I don’t know how they had CVs good for that. Anyways I matched into my 8th choice on ROL in first iteration. Since match day I have had many different emotions. In hindsight I wish I had known many things, especially how unforgiving Carms is. The thought of not ranking a program if I don’t want to do it is easy to say but when I submitted ROL my goal was to match no matter what. I had many friends who went unmatched last year and joined our match, on Carms tour there were people who were applying with Med5 year. I have HIGH respect for them but I did not have it in me to go unmatched and do Med 5 especially with senior residents saying during the tour - if you don’t match this year don’t come back. Anyways now as I start residency I hope I can get excited once I start working, I have thought of transferring but that is like winning the lottery. If there was a way to make Carms less of a one shot deal I’m all for it, it really should not be this way.

Thanks for reading, just wanted to vent I guess. All the best to applicants going through Carms this year!

I just want to congratulate you that you matched. In a way you are lucky that you misunderstood the CaRMS algorithm, otherwise, you might end up unmatched.

Being unmatched is not fun. Doing a med-5 year is not offered at all universities, it's a very depressing year when everyone thinks that there is something wrong with you, or you are not an equally strong candidate. If you look through the carms stats, the subsequent match rates for unmatched CMGs are not very promising years after years. The tragic case of Dr Robert Chu should ring some bell.

There is seriously no point of having a MD degree from a Canadian medical school, if you can't secure a residency spot. It's a glorifying but at the same time empty title, but does not guarantee anything until you attain a residency position, and become an independent practitioner later on. 

People think that getting into medical school should guarantee them to pursue whatever specialties they want, and would rather go unmatched than being in back up specialty. But the realistic statistics have proven that you really want to match into the first round of CaRMS, rather than scrambling for positions in second iteration. There are always stigmatization associated with unmatched CMGs for the next year match, even though there was no red flag on your file, and you did everything perfectly well. That's how our profession is unfortunately.

The CaRMs algorithm actually won the nobel prize, I believe? The algorithm really protects you for being matched if you are open and flexible. If there is something to blame for unmatched CMGs, it is the lack of funding of each province to open up more residency spots which put unmatched CMGs into a vicious cycle. 

 

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On 6/22/2019 at 10:19 AM, doc_tr said:

These are some excellent points, I am glad to have matched but my aim in writing here was really to make people aware that you may not get your 1-3 choice. I was given the advice that you do not go down the ROL much everyone gets one of their top 3, but that is not the case. I definitely would’ve changed my ROL had I thought it would go down past the top 3-4.  

Thank you everyone for all the support, I appreciate knowing I’m not the only one in this boat this year.

Yeah, it does happen to go deep down the ROL...

I spend quite a lot of time carefully deciding my ROL from #1 up to the very last one. And I didn't rank a program I absolutely didn't want to be at for the next 5 years of my life. I do believe it's a valuable advice to those who are applying (will apply someday) to carefully consider every single program in their ROL. When doing my ROL, at every entry I'd ask myself "if I match there, how would I feel about staying in that program and location for next years and doing that special for the rest of my life?". 

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On 6/24/2019 at 3:10 AM, JohnGrisham said:

So essentially you didnt know how ROL works and that you should always rank by preference. You're implying here that had you known you could go down your list...you wouldve ranked differently. I still dont understand how this happens that very intelligent people year after year dont understand a simple algorithm..

 

 

On 6/24/2019 at 10:39 AM, LittleDaisy said:

I just want to congratulate you that you matched. In a way you are lucky that you misunderstood the CaRMS algorithm, otherwise, you might end up unmatched.

I think what OP meant was that he/she didn't put as much thought into his/her ranks after the top 3 choices as much as he/she should have.

This is not an uncommon misconception. When I went through the match, people were talking about how matching to any choice past your 7th-8th was almost 0% so the ranking wouldn't matter. Fundamentally a lot of med students don't understand the stats, don't look at the data themselves, and/or are overly eager to listen to optimistic hearsay.

To the med students out there, rank wherever you would considering going. I know of people matching to a double digit choice. It's still better than going unmatched.

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On 7/21/2019 at 5:40 PM, 1D7 said:

 

I think what OP meant was that he/she didn't put as much thought into his/her ranks after the top 3 choices as much as he/she should have.

This is not an uncommon misconception. When I went through the match, people were talking about how matching to any choice past your 7th-8th was almost 0% so the ranking wouldn't matter. Fundamentally a lot of med students don't understand the stats, don't look at the data themselves, and/or are overly eager to listen to optimistic hearsay.

To the med students out there, rank wherever you would considering going. I know of people matching to a double digit choice. It's still better than going unmatched.

I think its also a problem with the grass is always greener on the other side. People who didn't match regret not ranking more programs because they thought they would match within their top -10 and people who match to a bad location or a back up specialty have second thoughts about ranking those particular programs.

For me, I ranked everything because I abhored the thought of being unmatched. But people always told me you will 99.9% match to your top 3 and how you have a bigger chance of being unmatched than matching outside your top 5. So I never mentally expected to match past my 5th choice which was a fear I had during the CaRMS tour. Ultimately, I did not match to the place I wanted to be but its still close to home and in an amazing program. My CaRMS result was bittersweet but I felt grateful when I compared myself to people I knew who matched far from home in their back up specialty.

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4 hours ago, hero147 said:

I think its also a problem with the grass is always greener on the other side. People who didn't match regret not ranking more programs because they thought they would match within their top -10 and people who match to a bad location or a back up specialty have second thoughts about ranking those particular programs.

For me, I ranked everything because I abhored the thought of being unmatched. But people always told me you will 99.9% match to your top 3 and how you have a bigger chance of being unmatched than matching outside your top 5. So I never mentally expected to match past my 5th choice which was a fear I had during the CaRMS tour. Ultimately, I did not match to the place I wanted to be but its still close to home and in an amazing program. My CaRMS result was bittersweet but I felt grateful when I compared myself to people I knew who matched far from home in their back up specialty.

It's a combination of grass is greener on the other side... and a matter of you don't know what you're getting into until it happens. When you go unmatched, even a residency doing family medicine in rural Newfoundland might sound great, because it's better than being unemployed for a whole year. No offense to Newfoundland. But then you actually end up in rural Newfoundland and maybe now you hate it because of how far away you are from everything you care about, and you're thinking how great life would have been if you got plastic surgery in Toronto.

The CaRMS match is a many-edged sword. Unfortunately the match is for the most part a one-shot deal, it will make and break your dreams. You have to think so carefully about what you actually want, keeping in mind the tremendous risks and costs of going unmatched. There's too many variables to consider. I don't advocate blaming people for ending up in their backup choice, like #27 on their rank list, because they were really choosing between a sharp rock and very hard place. Do you go unmatched and incur another year of debt while doing a 5th year of med school? With no guarantee of matching. Or do you bite the bullet and backup to family medicine in the middle of nowhere? You've spent your whole life working hard for your dream, and now you have to choose between 28 different choices, knowing that your choice is largely irreversible. That's just not fair.

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19 hours ago, shematoma said:

It's a combination of grass is greener on the other side... and a matter of you don't know what you're getting into until it happens. When you go unmatched, even a residency doing family medicine in rural Newfoundland might sound great, because it's better than being unemployed for a whole year. No offense to Newfoundland. But then you actually end up in rural Newfoundland and maybe now you hate it because of how far away you are from everything you care about, and you're thinking how great life would have been if you got plastic surgery in Toronto.

The CaRMS match is a many-edged sword. Unfortunately the match is for the most part a one-shot deal, it will make and break your dreams. You have to think so carefully about what you actually want, keeping in mind the tremendous risks and costs of going unmatched. There's too many variables to consider. I don't advocate blaming people for ending up in their backup choice, like #27 on their rank list, because they were really choosing between a sharp rock and very hard place. Do you go unmatched and incur another year of debt while doing a 5th year of med school? With no guarantee of matching. Or do you bite the bullet and backup to family medicine in the middle of nowhere? You've spent your whole life working hard for your dream, and now you have to choose between 28 different choices, knowing that your choice is largely irreversible. That's just not fair.

LOL! Hello from Newfoundland rural family resident! Fortunately I came here by choice hahaha. 

That said, going to a place you didn't want to is pretty brutal. But important to remember that residency is a time limited business and, to be honest, most of the time you're circulating in the hospital. Even if it's not where you want to go, a lot of programs are very negotiable about getting you additional learning opportunities that you need.

OP: At this point. since you've already matched, I think the best/only thing to do is chin up, get through the first year of residency, and keep an open mind. If you find during it that you're just plain miserable where you are, look into transferring and prepare your connections early before carms next year. 

*Plug for rural family in NL: it's kind of really awesome! 

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On 7/24/2019 at 6:47 PM, GrouchoMarx said:

Just another friendly plug for taking the USMLEs.

With the 8 week elective cap, it doesnt really make sense to take the USMLEs since you wont be able to rotate in the US without hurting your CARMS application... 

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30 minutes ago, MDinCanada said:

With the 8 week elective cap, it doesnt really make sense to take the USMLEs since you wont be able to rotate in the US without hurting your CARMS application... 

Its not as necessary to rotate all around in the US, like it is in Canada. Strong board scores and an otherwise good on paper application speaks volumes to get to the interviews. Sure you might be region locked in some places like California, but overall plenty of excellent options will give you a interview with the right on-paper looks.

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10 hours ago, JohnGrisham said:

Its not as necessary to rotate all around in the US, like it is in Canada. Strong board scores and an otherwise good on paper application speaks volumes to get to the interviews. Sure you might be region locked in some places like California, but overall plenty of excellent options will give you a interview with the right on-paper looks.

this is the truth.

in the states there are standardized indicators of competitiveness. flying around sucking up to program directors isnt really a thing there outside of derm.

canada has it ass backwards.

dont let thinking you need to do electives in the usa stop you from applying. you dont need to do electives to match there. its not like canada. its more reasonable and overall a better system.

i hope more canadian medical students go to the usa for spite. we are so spineless tolerating this bullshit

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7 hours ago, GrouchoMarx said:

this is the truth.

in the states there are standardized indicators of competitiveness. flying around sucking up to program directors isnt really a thing there outside of derm.

canada has it ass backwards.

dont let thinking you need to do electives in the usa stop you from applying. you dont need to do electives to match there. its not like canada. its more reasonable and overall a better system.

i hope more canadian medical students go to the usa for spite. we are so spineless tolerating this bullshit

I think applying to US residencies as CDN Med students are not as easy as we think. First, CaRMs come first, so you automatically get removed from the US match and for most people, they had to take a fairly big risk to rank US programs ONLY. Also, US residency programs value prestige and USMLE scores, so unless you come from a big name med school and totally own the USMLE (which is difficult to study for in CDN schools since they dont teach the material. But honestly, they should and faculty should encourage students to take USMLEs..), your chance IMO are low. We tend to think our med schools are some of the best in the world, but US PDs have a huge bias towards US applicants and they want to see heavy research. Someone should protest to make CaRMs match after NRMP though...

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